| NPI | 1265683148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: TN MT1213) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN MT0000001213) |
| Enumeration Date | 2008-10-09 |
| Last Update Date | 2012-07-19 |