| NPI | 1871905471 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: SC MAS 9765) |
| Additional Taxonomies | 171W00000X Contractor (Licence: GA MT009659) |
| 225700000X Massage Therapist (Licence: GA MT009659) | |
| Enumeration Date | 2014-05-30 |
| Last Update Date | 2016-09-26 |