| NPI | 1063916229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: GA 010112) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MA 3601) |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2019-01-23 |