| NPI | 1962534891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: ID 034956-00) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA 024201MA00015161) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2007-07-08 |