| NPI | 1508028457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AZ 8180) |
| Additional Taxonomies | 111NR0400X Chiropractor Rehabilitation (Licence: AZ 4830) |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2012-12-31 |