| NPI | 1639579907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WI 5037-12) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MN 5942) |
| Enumeration Date | 2014-08-24 |
| Last Update Date | 2018-03-17 |