| NPI | 1023409059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: VA 0104557642) |
| Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician (Licence: UT 9297663-1202) |
| Enumeration Date | 2015-02-12 |
| Last Update Date | 2021-09-13 |