| NPI | 1235398553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: ME 37578) |
| Additional Taxonomies | 222Z00000X |
| 174400000X Specialist (Licence: ME OA2580) | |
| 174400000X Specialist (Licence: ME MT714) | |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2012-04-11 |