NPI | 1538106141 |
---|---|
Former Name | SUSAN LYNN BROEKHUIZEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 111NR0200X Chiropractor, Radiology (Licence: HI DC-1296) |
Additional Taxonomies | 111NR0200X Chiropractor, Radiology (Licence: MI 2301008926) |
111N00000X Chiropractor (Licence: HI DC-1296) | |
Enumeration Date | 2006-06-01 |
Last Update Date | 2016-03-03 |