| NPI | 1740600519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: TN 10218) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: TN 66267) |
| Enumeration Date | 2014-04-21 |
| Last Update Date | 2014-04-21 |