| NPI | 1467986083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor (Licence: MT 50238) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MT 780) |
| Enumeration Date | 2017-04-20 |
| Last Update Date | 2017-04-21 |