| NPI | 1215691423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: GA MT012313) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: UT 8345577-4701) |
| Enumeration Date | 2021-10-25 |
| Last Update Date | 2021-10-25 |