| NPI | 1790043073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: KY KY-0967) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: IN MT20901301) |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2022-03-08 |