| NPI | 1689055840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: CA 35970) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: CA 1478827) |
| Enumeration Date | 2015-06-13 |
| Last Update Date | 2015-06-13 |