| NPI | 1164888608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: MA61025411) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: ID Masg-2129) |
| Enumeration Date | 2016-01-13 |
| Last Update Date | 2024-07-06 |