| NPI | 1619177342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NE 1613) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: SD 1110) |
| 111N00000X Chiropractor (Licence: MN 4938) | |
| 111N00000X Chiropractor (Licence: AZ 7975) | |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2010-04-01 |