| NPI | 1275607079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor (Licence: TX MT3332) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: TX MT3332) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2007-07-08 |