| NPI | 1235642430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: MT 12521) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: MT LMT-LMT-12521) |
| Enumeration Date | 2017-11-09 |
| Last Update Date | 2017-11-09 |