| NPI | 1790503399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: NJ 18KT00866200) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: PA MSG015502) |
| 225700000X Massage Therapist (Licence: TX MT109298) | |
| Enumeration Date | 2024-10-01 |
| Last Update Date | 2024-10-01 |