| NPI | 1699140756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WI 5120) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MN 6085) |
| Enumeration Date | 2015-12-01 |
| Last Update Date | 2015-12-01 |