| NPI | 1790259158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MO 2019001368) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MO 2019001369) |
| Enumeration Date | 2019-01-17 |
| Last Update Date | 2019-01-17 |