| NPI | 1851828842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: TX MT126192) |
| Additional Taxonomies | 305S00000X Point of Service (Licence: TX MT126192) |
| Enumeration Date | 2017-05-22 |
| Last Update Date | 2017-05-22 |