NPI | 1548492168 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: MD 03626) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: VA 0104556739) |
Enumeration Date | 2009-08-15 |
Last Update Date | 2018-01-03 |