| NPI | 1275021719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: WA MA60745365) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OR 22952) |
| Enumeration Date | 2018-04-30 |
| Last Update Date | 2018-04-30 |