NPI | 1205180684 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: AZ 8266) |
Additional Taxonomies | 111NR0400X Chiropractor, Rehabilitation (Licence: AZ 8266) |
Enumeration Date | 2012-11-06 |
Last Update Date | 2016-12-01 |