| NPI | 1518121961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: WA MA00024569) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OR 11510) |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2012-05-04 |