| NPI | 1043421563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NR0400X (Licence: MD 01979) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MD 01979) |
| 111N00000X Chiropractor (Licence: VA 0104555714) | |
| 111NN0400X Chiropractor, Neurology (Licence: MD 01979) | |
| 111NN0400X Chiropractor, Neurology (Licence: VA 0104555714) | |
| 111NR0400X (Licence: VA 0104555714) | |
| 111NS0005X Chiropractor, Sports Physician (Licence: MD 01979) | |
| 111NS0005X Chiropractor, Sports Physician (Licence: VA 0104555714) | |
| 111NX0100X Chiropractor, Occupational Health (Licence: MD 01979) | |
| 111NX0100X Chiropractor, Occupational Health (Licence: VA 0104555714) | |
| 111NX0800X Chiropractor, Orthopedic (Licence: MD 01979) | |
| 111NX0800X Chiropractor, Orthopedic (Licence: VA 0104555714) | |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2008-03-03 |