| NPI | 1972045649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: WV 2003-1177) |
| Additional Taxonomies | 171W00000X Contractor (Licence: WV WV2003-1177) |
| Enumeration Date | 2016-11-13 |
| Last Update Date | 2017-02-21 |