| NPI | 1073997342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: TX 12946) |
| Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician (Licence: TX 12946) |
| 111NS0005X Chiropractor, Sports Physician (Licence: MI 12946) | |
| 163W00000X Registered Nurse (Licence: TX 965749) | |
| 363L00000X Nurse Practitioner (Licence: TX 1099962) | |
| Enumeration Date | 2015-07-16 |
| Last Update Date | 2022-12-02 |