| NPI | 1679716039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MO 2012037196) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: SC 3445) |
| Enumeration Date | 2009-04-15 |
| Last Update Date | 2012-12-21 |