| NPI | 1265978506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CT 001392) |
| Additional Taxonomies | 111NI0900X Chiropractor, Internist (Licence: CT 001392) |
| Enumeration Date | 2017-01-10 |
| Last Update Date | 2019-06-06 |