NPI | 1730635640 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: HI 136) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NJ 25MT00067100) |
225700000X Massage Therapist (Licence: NJ 18KT00365100) | |
225700000X Massage Therapist (Licence: HI 12938) | |
Enumeration Date | 2016-08-31 |
Last Update Date | 2018-08-21 |