| NPI | 1346542503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP010955) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OR 24632) |
| Enumeration Date | 2010-11-21 |
| Last Update Date | 2021-10-01 |