| NPI | 1770613309 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MO CE5196) |
| Additional Taxonomies | 111NR0400X (Licence: MO CE5196) |
| 111NS0005X Chiropractor, Sports Physician (Licence: MO CE5196) | |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2010-12-06 |