NPI | 1073150405 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 246Z00000X Specialist/Technologist, Other (Licence: MD EO1465) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: MD M05663) |
Enumeration Date | 2019-12-04 |
Last Update Date | 2021-08-18 |