| NPI | 1154075380 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225700000X Massage Therapist (Licence: NJ 18KT01409400) | 
| Additional Taxonomies | 225700000X Massage Therapist (Licence: GA MT013720) | 
| Enumeration Date | 2022-02-07 | 
| Last Update Date | 2022-02-07 |