| NPI | 1093747834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: CO 13085) |
| Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: OH 67000049) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2014-03-11 |