| NPI | 1326199951 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT 19174) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MT 930) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2015-10-01 |