| NPI | 1255005070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: ID Mad-2994) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: ID Mas-2994) |
| Enumeration Date | 2021-08-04 |
| Last Update Date | 2021-09-29 |