| NPI | 1134593825 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: WA MA00021566) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OR 11841) |
| Enumeration Date | 2015-11-19 |
| Last Update Date | 2015-11-19 |