| NPI | 1356615504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WM1400X Registered Nurse, Nurse Massage Therapist (NMT) (Licence: NY 640956-1) |
| Additional Taxonomies | 163WM1400X Registered Nurse, Nurse Massage Therapist (NMT) (Licence: NY 020418-1) |
| Enumeration Date | 2012-03-06 |
| Last Update Date | 2012-03-06 |