| NPI | 1639307473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MI 2301009510) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WI 4973-12) |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2019-10-02 |