| NPI | 1366784894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: SD MT12103) |
| Additional Taxonomies | 174400000X Specialist (Licence: CO MT.0010652) |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2024-12-09 |