| NPI | 1376819219 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MI 2301009599) | 
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MI L1646945) | 
| Enumeration Date | 2012-03-26 | 
| Last Update Date | 2021-09-10 |