| NPI | 1306481247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: AZ 18456) |
| Additional Taxonomies | 225000000X Orthotic Fitter (Licence: AZ 18456) |
| Enumeration Date | 2019-11-14 |
| Last Update Date | 2019-11-14 |