| NPI | 1154669869 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: ID MAS-4453) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: UT 7890249-4701) |
| Enumeration Date | 2013-01-30 |
| Last Update Date | 2021-09-24 |