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