NPI | 1033517107 |
---|---|
Former Name | JESSICA MARTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MS 1253) |
Additional Taxonomies | 111NP0017X Chiropractor, Pediatric Chiropractor (Licence: TX 12477) |
Enumeration Date | 2014-12-05 |
Last Update Date | 2022-07-21 |