| NPI | 1164870382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: CO MT0018985) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: AZ MT-06527) |
| Enumeration Date | 2016-05-27 |
| Last Update Date | 2016-05-27 |