NPI | 1417313552 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MO 2016000180) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MO 1848) |
Enumeration Date | 2016-01-05 |
Last Update Date | 2022-09-02 |