| NPI | 1518411719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: WA MA 60608023) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OR OR 22089) |
| Enumeration Date | 2016-08-05 |
| Last Update Date | 2016-08-05 |