| NPI | 1457614455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MO 2012013893) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: KS 01-05667) |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2021-06-14 |