| NPI | 1619211919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: GA MT007221) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: MI 7501007926) |
| Enumeration Date | 2012-11-27 |
| Last Update Date | 2022-03-23 |