| NPI | 1366258949 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225700000X Massage Therapist (Licence: WA MA1329463)  | 
| Additional Taxonomies | 225700000X Massage Therapist (Licence: ID MAS-4755)  | 
| Enumeration Date | 2024-12-09 | 
| Last Update Date | 2024-12-09 |