| NPI | 1356607691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171W00000X Contractor (Licence: CO 10094) |
| Additional Taxonomies | 111NR0400X Chiropractor, Rehabilitation (Licence: CO 10094) |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2012-04-11 |