| NPI | 1063447688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: TX 10086) |
| Additional Taxonomies | 111NS0005X Chiropractor Sports Physician (Licence: TX 10086) |
| 111NR0400X Chiropractor Rehabilitation (Licence: TX 10086) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2008-07-01 |