| NPI | 1083171151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: MI 7501000228) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MI 4703113427) |
| Enumeration Date | 2019-02-26 |
| Last Update Date | 2019-02-26 |