| NPI | 1942433750 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: LA 225700000X) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: LA LMT #4024-01) |
| Enumeration Date | 2009-08-26 |
| Last Update Date | 2009-08-26 |