| NPI | 1174896724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OR 5660) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 111N00000X Chiropractor (Licence: TX 12368) | |
| 111N00000X Chiropractor (Licence: NC 4258) | |
| Enumeration Date | 2012-02-13 |
| Last Update Date | 2020-06-30 |