| NPI | 1629485644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: WA MA60473431) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: AZ MT-11356) |
| Enumeration Date | 2014-07-22 |
| Last Update Date | 2015-01-05 |