| NPI | 1104293273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: OR 27101) |
| Additional Taxonomies | 174400000X Specialist (Licence: CO MT.0016850) |
| Enumeration Date | 2015-08-25 |
| Last Update Date | 2023-07-10 |