| NPI | 1093297426 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MO 2023046993) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MN 7117) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MO 2020009473) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MN 3692) | |
| Enumeration Date | 2018-09-01 |
| Last Update Date | 2023-12-13 |