| NPI | 1235367624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: HI MAT 9697) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: VA CMT 0019006122) |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2009-06-24 |