| NPI | 1104483767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 34243) |
| Additional Taxonomies | 111NR0400X (Licence: CA 34243) |
| 111NN1001X Chiropractor, Nutrition (Licence: CA 34243) | |
| 111NP0017X Chiropractor, Pediatric Chiropractor (Licence: CA 34243) | |
| Enumeration Date | 2019-05-20 |
| Last Update Date | 2019-05-20 |