| NPI | 1790080083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: MT 876) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: GA 000758) |
| Enumeration Date | 2011-01-18 |
| Last Update Date | 2011-01-26 |