| NPI | 1790807360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MO 2001000493) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MO 050107) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2009-04-23 |