| NPI | 1609429968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3747A0650X Technician, Attendant Care Provider (Licence: IL none) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: IL 227020616) |
| Enumeration Date | 2019-07-16 |
| Last Update Date | 2026-04-22 |