| NPI | 1366721250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: OR 17974) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OR 17974) |
| Enumeration Date | 2011-08-09 |
| Last Update Date | 2012-01-27 |