| NPI | 1265773519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: ND 1067) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MN 5354) |
| Enumeration Date | 2013-03-12 |
| Last Update Date | 2018-03-17 |