| 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 |