| NPI | 1457998312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: PA MSG012368) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NJ 18KT01256400) |
| Enumeration Date | 2019-12-10 |
| Last Update Date | 2019-12-10 |