| NPI | 1649549684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: HI MAT11291) |
| Additional Taxonomies | 171W00000X Contractor (Licence: HI MAT 11291) |
| Enumeration Date | 2011-12-20 |
| Last Update Date | 2021-03-05 |