| NPI | 1295276764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: GA CHIR010508) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL5002) |
| Enumeration Date | 2017-03-16 |
| Last Update Date | 2021-03-23 |