NPI | 1154872208 |
---|---|
Former Name | EVONNE NELSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171100000X Acupuncturist (Licence: WA AC60716212) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: WA MA00020042) |
Enumeration Date | 2016-10-24 |
Last Update Date | 2020-07-08 |