| NPI | 1790015873 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: WA MA00017043) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OR 9432) |
| Enumeration Date | 2010-01-12 |
| Last Update Date | 2010-01-12 |