| NPI | 1508365875 |
|---|---|
| Former Name | NICOLE MARIE DOUGHERTY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: SC 4567) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: VA 0104-557475) |
| Enumeration Date | 2018-02-01 |
| Last Update Date | 2022-11-01 |