| NPI | 1912438110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: GA MT011771) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: AZ MT-23019) |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2019-11-23 |