| NPI | 1104297365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: SC 12751) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NC 5590) |
| Enumeration Date | 2015-10-14 |
| Last Update Date | 2023-09-27 |