| NPI | 1194071696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: ND 920) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MN 5676) |
| Enumeration Date | 2012-08-02 |
| Last Update Date | 2015-02-23 |