NPI | 1649699455 |
---|---|
Former Name | KACY LEANN BORBA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 175F00000X Naturopath (Licence: OR 2022) |
Additional Taxonomies | 171100000X Acupuncturist (Licence: OR AC167588) |
174400000X Specialist (Licence: OR 20290) | |
Enumeration Date | 2014-04-08 |
Last Update Date | 2022-01-28 |