| NPI | 1790313351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: HI 19372) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: HI 16578) |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2022-05-10 |