| NPI | 1609338052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AK 223574) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA MA60924280) |
| Enumeration Date | 2019-04-04 |
| Last Update Date | 2024-06-13 |