| NPI | 1760012512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: KS THR-065184) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: MO 2009024312) |
| Enumeration Date | 2020-01-21 |
| Last Update Date | 2020-01-21 |