| NPI | 1063770485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MO 2014037142) |
| Additional Taxonomies | 111NR0400X (Licence: IN 08002630A) |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2016-01-04 |