| NPI | 1700400397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 202K00000X (Licence: FL 22-0830) |
| 225700000X Massage Therapist | |
| 183700000X Pharmacy Technician | |
| Enumeration Date | 2020-05-30 |
| Last Update Date | 2022-05-27 |