| NPI | 1912106543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: MA00018521) |
| Additional Taxonomies | 172M00000X Mechanotherapist (Licence: WA MA00018521) |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2010-03-29 |