| NPI | 1679771760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 30434) |
| Additional Taxonomies | 111NP0017X Chiropractor, Pediatric Chiropractor (Licence: WI 4501-012) |
| 111NS0005X Chiropractor, Sports Physician (Licence: WI 4502-012) | |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2019-02-20 |