| NPI | 1962916742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: OR LMT-14584) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OR 14584) |
| Enumeration Date | 2017-11-30 |
| Last Update Date | 2017-11-30 |