| NPI | 1104497916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: WA 61113339) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA MA61113339) |
| 225700000X Massage Therapist (Licence: OR 25936) | |
| Enumeration Date | 2021-07-02 |
| Last Update Date | 2022-02-28 |