| NPI | 1609404250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: KS THR-060707) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: MO 2005034943) |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2020-03-30 |