| NPI | 1326830373 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: CA 98743) |
| Additional Taxonomies | 246RP1900X Technician, Pathology, Phlebotomy (Licence: HI Y4Y2D5E5) |
| Enumeration Date | 2025-05-17 |
| Last Update Date | 2025-05-17 |