| NPI | 1720741515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: NJ 18KT01394800) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: PA MSG014123) |
| Enumeration Date | 2021-10-19 |
| Last Update Date | 2021-10-19 |