| NPI | 1225109697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: FL MA 40573) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NC 4553) |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2007-07-08 |