| NPI | 1578787651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: GA CHIRO07709) |
| Additional Taxonomies | 111NN0400X Chiropractor Neurology (Licence: GA CHIRO07709) |
| 111NR0200X Chiropractor Radiology (Licence: GA CHIRO07709) | |
| 111NR0400X Chiropractor Rehabilitation (Licence: GA CHIRO07709) | |
| 111NS0005X Chiropractor Sports Physician (Licence: GA CHIRO07709) | |
| 111NT0100X Chiropractor Thermography (Licence: GA CHIRO07709) | |
| 111NX0800X Chiropractor Orthopedic (Licence: GA CHIRO07709) | |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2007-07-08 |