| NPI | 1861039083 |
|---|---|
| Former Name | GRETCHEN MARIE BORGES LEON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 202D00000X (Licence: PR 60) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: PR 60) |
| Enumeration Date | 2019-12-06 |
| Last Update Date | 2023-06-01 |