| NPI | 1568656601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: TN MT0000003344) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: KY KY-0187) |
| Enumeration Date | 2007-08-31 |
| Last Update Date | 2007-08-31 |