| NPI | 1376422709 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2472E0500X Technician, Other, EEG (Licence: MA E6866) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: MA MT-12276) |
| Enumeration Date | 2025-08-29 |
| Last Update Date | 2025-08-29 |