| NPI | 1780560862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: GA Chiro11366) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: LA 2061) |
| Enumeration Date | 2025-08-13 |
| Last Update Date | 2026-01-26 |