| NPI | 1639687601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: MO 2017041330) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: TX 122381) |
| Enumeration Date | 2018-01-12 |
| Last Update Date | 2026-04-13 |