| NPI | 1558905851 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: ME MT1541) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: ME MT1541) |
| Enumeration Date | 2019-10-30 |
| Last Update Date | 2019-10-30 |