| NPI | 1760763940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172M00000X Mechanotherapist (Licence: CO 11483) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: CO 11483) |
| Enumeration Date | 2011-09-01 |
| Last Update Date | 2011-10-07 |