| NPI | 1417064247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: VA 0104000673) |
| Additional Taxonomies | 111NS0005X Chiropractor Sports Physician (Licence: VA 3550) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2012-03-22 |