| NPI | 1558146795 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225700000X Massage Therapist (Licence: NH 8245) | 
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL 2714012) | 
| Enumeration Date | 2023-08-28 | 
| Last Update Date | 2023-08-28 |