| NPI | 1730620311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: NY 028682-1) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NJ 18KT00681900) |
| Enumeration Date | 2017-03-15 |
| Last Update Date | 2017-03-15 |