| NPI | 1356186498 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: VT 164.0001657) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NH 8662) |
| Enumeration Date | 2024-06-29 |
| Last Update Date | 2024-06-29 |