| NPI | 1083346993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: KS 01-06215) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MO 2022024515) |
| 225000000X Orthotic Fitter (Licence: C54312) | |
| Enumeration Date | 2022-06-29 |
| Last Update Date | 2025-03-11 |