| NPI | 1114425501 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: TN MT10893) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NC 17334) |
| Enumeration Date | 2018-01-31 |
| Last Update Date | 2020-12-18 |