| NPI | 1669016762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: SD MT10205) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NE 3221) |
| 225700000X Massage Therapist (Licence: IA 072397) | |
| Enumeration Date | 2019-10-31 |
| Last Update Date | 2019-10-31 |