| 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 |