NPI | 1205106994 |
---|---|
Former Name | LULU TARA ROSE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171100000X Acupuncturist (Licence: MI 5401-000026) |
Additional Taxonomies | 171100000X Acupuncturist (Licence: CO 1776) |
Enumeration Date | 2012-01-11 |
Last Update Date | 2019-02-15 |