| NPI | 1649869264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: GA MT001526) |
| Additional Taxonomies | 224L00000X Pedorthist (Licence: GA CPed4585) |
| Enumeration Date | 2021-01-18 |
| Last Update Date | 2021-01-18 |