| NPI | 1558484758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: GA 3040) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: SC 1363) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2007-07-08 |