| NPI | 1518068089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: GA 3030) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: GA 3030) |
| 111NN1001X Chiropractor, Nutrition (Licence: GA 3030) | |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2015-10-20 |