| NPI | 1043587157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NR0400X (Licence: CA 32073) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 32073) |
| 111NS0005X Chiropractor, Sports Physician (Licence: CA 32073) | |
| Enumeration Date | 2011-11-18 |
| Last Update Date | 2011-11-18 |