| NPI | 1659326304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: WA MA60242466) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OR 10892) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2012-09-14 |