| NPI | 1619150158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: FL MA41123) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: FL PN874041) |
| Enumeration Date | 2007-12-06 |
| Last Update Date | 2007-12-06 |