| NPI | 1912603754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171400000X (Licence: TX CERTIFICATE) |
| Additional Taxonomies | 171400000X (Licence: TX 1643097) |
| 225700000X Massage Therapist (Licence: TX MT130964) | |
| Enumeration Date | 2023-02-02 |
| Last Update Date | 2023-02-02 |