| NPI | 1154751337 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: AZ MT24112) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA MA60423642) |
| Enumeration Date | 2013-11-25 |
| Last Update Date | 2019-03-05 |