| NPI | 1679976765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: WA MA60097213) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: UT 4856612-4701) |
| Enumeration Date | 2014-10-02 |
| Last Update Date | 2015-12-01 |