| NPI | 1811335466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: VA 0019008767) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: VA 0126001759) |
| Enumeration Date | 2013-06-05 |
| Last Update Date | 2013-06-05 |