NPI | 1366670853 |
---|---|
Former Name | DOREA LEIGH WILDER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: TX 11777) |
Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician (Licence: TX 5200) |
Enumeration Date | 2009-06-23 |
Last Update Date | 2023-05-24 |