| NPI | 1588023501 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: ID MAS-4161) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OR 22003) |
| Enumeration Date | 2016-02-18 |
| Last Update Date | 2022-09-06 |