| NPI | 1790110781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: SC 53144) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: SC 7700) |
| Enumeration Date | 2013-09-09 |
| Last Update Date | 2024-12-04 |