| NPI | 1164685939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: WA MA00024230) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OR 11923) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2008-07-02 |