| NPI | 1154795474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: UT 10712283-4701) |
| Additional Taxonomies | 172M00000X Mechanotherapist |
| 174400000X Specialist | |
| Enumeration Date | 2015-11-24 |
| Last Update Date | 2020-08-25 |