| NPI | 1700169935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: MA61380) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner (Licence: FL MA61380) |
| Enumeration Date | 2011-09-23 |
| Last Update Date | 2011-09-23 |