| NPI | 1104179514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: FL MA63569) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: PA MSG 002567) |
| Enumeration Date | 2012-10-23 |
| Last Update Date | 2012-10-23 |