| NPI | 1578794764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: WV 2004-1547) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WV 2004-1547) |
| Enumeration Date | 2009-08-05 |
| Last Update Date | 2021-11-17 |