| NPI | 1104401421 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: OR 24711) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA MA61137617) |
| Enumeration Date | 2021-03-17 |
| Last Update Date | 2022-02-02 |