| NPI | 1811961733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: AZ ATR001440) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: AZ ATR001440) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2018-11-09 |