| NPI | 1790379717 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225700000X Massage Therapist (Licence: CA 60248) | 
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NV NVMT.5944) | 
| Enumeration Date | 2021-02-22 | 
| Last Update Date | 2021-02-22 |