| NPI | 1154033363 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225700000X Massage Therapist (Licence: NY 029414-01) | 
| Additional Taxonomies | 225700000X Massage Therapist (Licence: CT 10729) | 
| Enumeration Date | 2022-12-19 | 
| Last Update Date | 2022-12-19 |