| NPI | 1902204837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: PA PN289393) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: PA MSG011132) |
| Enumeration Date | 2014-12-09 |
| Last Update Date | 2025-08-11 |