| NPI | 1164616587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OR 3066) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: VT 006 0001154) |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2021-04-11 |