| NPI | 1174028328 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: ID MAS-3301) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: TX MT103802) |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2018-03-29 |