| NPI | 1174757546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: PA MSG001853) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NY 009817-1) |
| 225700000X Massage Therapist (Licence: TX MT 113367) | |
| Enumeration Date | 2009-05-13 |
| Last Update Date | 2011-08-23 |