| NPI | 1962056630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: ID MAS4661) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA MA60981993) |
| Enumeration Date | 2019-07-30 |
| Last Update Date | 2024-12-16 |