| NPI | 1669437679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: PA MSG000066) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: PA PN258952L) |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2011-03-21 |