| NPI | 1104162734 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: PA msg#001077) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NY LIC#013454) |
| Enumeration Date | 2013-01-01 |
| Last Update Date | 2013-01-01 |