| NPI | 1851846968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: LA La5480) |
| Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: LA LMT5480) |
| Enumeration Date | 2016-08-18 |
| Last Update Date | 2016-09-13 |