| NPI | 1376687210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: GA chiro07391) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: PR 384) |
| 111NP0017X Chiropractor, Pediatric Chiropractor (Licence: GA chiro07391) | |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2013-04-17 |