| NPI | 1790007771 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: KS 01-05310) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MO 2010005620) |
| Enumeration Date | 2010-02-18 |
| Last Update Date | 2010-02-18 |