| NPI | 1275178279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224900000X Mastectomy Fitter (Licence: VA CFm00767) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: VA 0019016343) |
| Enumeration Date | 2019-11-13 |
| Last Update Date | 2019-11-13 |