| NPI | 1992129662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: CO 0015115) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WI 4268-146) |
| Enumeration Date | 2014-02-14 |
| Last Update Date | 2014-02-14 |