| NPI | 1366649337 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor (Licence: WA MA 00022064) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA MA0022064) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2024-05-09 |