| NPI | 1275876492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: MT 4131) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: CO 12765) |
| Enumeration Date | 2013-04-05 |
| Last Update Date | 2013-04-05 |