| NPI | 1619201340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MN 5277) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WI 4480-12) |
| Enumeration Date | 2009-09-29 |
| Last Update Date | 2016-10-05 |