| NPI | 1619346533 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225700000X Massage Therapist (Licence: OR 21605) | 
| Additional Taxonomies | 174400000X Specialist (Licence: OR 21606) | 
| Enumeration Date | 2015-09-21 | 
| Last Update Date | 2017-10-24 |