| NPI | 1144796251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: NY 031274) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NY 0002456) |
| Enumeration Date | 2018-10-16 |
| Last Update Date | 2018-10-16 |