| NPI | 1003243346 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: MT 708) |
| Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician (Licence: CO 708) |
| Enumeration Date | 2013-10-01 |
| Last Update Date | 2013-10-01 |