| NPI | 1811018633 |
|---|---|
| Former Name | LISA TOMKO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: MO 2001009355) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MO 114828) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2021-01-05 |