| NPI | 1760876692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: MT 1256) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: AZ MT-11794) |
| Enumeration Date | 2015-03-28 |
| Last Update Date | 2015-10-06 |