| NPI | 1265820690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: OR 19356) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OR 19356) |
| Enumeration Date | 2015-01-08 |
| Last Update Date | 2022-02-28 |