| NPI | 1114551397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: NY 012679-1) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 311363-1) |
| Enumeration Date | 2020-02-27 |
| Last Update Date | 2020-02-27 |