| NPI | 1386142826 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: WI 3710-146) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WI 620-39) |
| Enumeration Date | 2018-01-30 |
| Last Update Date | 2018-01-30 |