| NPI | 1083964449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: SD MT11886) |
| Additional Taxonomies | 172M00000X Mechanotherapist (Licence: OR 19182) |
| Enumeration Date | 2012-09-13 |
| Last Update Date | 2022-11-21 |