| NPI | 1760099014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: NE 1432) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NE 310) |
| Enumeration Date | 2020-09-29 |
| Last Update Date | 2020-09-29 |