| NPI | 1669138137 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: SD MT11843) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: AZ 2245383) |
| Enumeration Date | 2021-11-09 |
| Last Update Date | 2021-11-09 |