| NPI | 1780929687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: MI 7501010961) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA MA60303226) |
| Enumeration Date | 2012-12-03 |
| Last Update Date | 2019-04-18 |