| NPI | 1972791556 |
|---|---|
| Former Name | CARLY BRIANN PUNZALAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: ID MAS4614) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA MA00024004) |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2022-10-12 |