| NPI | 1699900506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: CO 6339) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: AZ MT-00416P) |
| Enumeration Date | 2009-05-20 |
| Last Update Date | 2009-05-20 |