| NPI | 1679982631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: NC 12973) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: SC MAS.9682) |
| Enumeration Date | 2014-08-04 |
| Last Update Date | 2021-03-18 |