| NPI | 1639314727 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor (Licence: OR 12596) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: OR AC180014) |
| Enumeration Date | 2008-12-03 |
| Last Update Date | 2018-03-17 |