| NPI | 1497340863 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225700000X Massage Therapist (Licence: TX 121987) | 
| Additional Taxonomies | 225700000X Massage Therapist (Licence: MO 2003016478) | 
| Enumeration Date | 2021-03-07 | 
| Last Update Date | 2021-03-07 |