| NPI | 1043977747 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: GA CHIR010527) |
| Additional Taxonomies | 111NS0005X Chiropractor Sports Physician (Licence: GA CHIR010527) |
| Enumeration Date | 2021-11-17 |
| Last Update Date | 2021-11-17 |