| NPI | 1922480656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: OR 21021) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: ID MAS-4774) |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2023-10-13 |