| NPI | 1871948315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: VA 0019007455) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: TX MT107551) |
| 225700000X Massage Therapist (Licence: MD MD # R02177) | |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2016-05-03 |