| NPI | 1568402394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: MO 2002030424) |
| Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician (Licence: KS 01-04816) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2012-08-14 |