| NPI | 1164760906 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225700000X Massage Therapist (Licence: WA MA00010616) | 
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OR 6267) | 
| Enumeration Date | 2013-01-29 | 
| Last Update Date | 2013-01-29 |