| NPI | 1083946578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MA 3313) |
| Additional Taxonomies | 111NS0005X Chiropractor Sports Physician (Licence: MA 3313) |
| Enumeration Date | 2010-02-08 |
| Last Update Date | 2019-02-07 |