| NPI | 1669619201 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: MS 2645) |
| Additional Taxonomies | 174400000X Specialist (Licence: WA MA 60018937) |
| Enumeration Date | 2009-01-20 |
| Last Update Date | 2020-01-16 |