| NPI | 1316530009 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225700000X Massage Therapist (Licence: GA MT003066) | 
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MA94696) | 
| Enumeration Date | 2021-02-15 | 
| Last Update Date | 2021-02-15 |