| NPI | 1770966517 |
|---|---|
| Former Name | CAITLYN JEAN BORUM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: AK 101482) |
| Additional Taxonomies | 225700000X Massage Therapist |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2019-04-22 |