| NPI | 1811254758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MO 2011019831) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: TN 0000002469) |
| Enumeration Date | 2012-04-17 |
| Last Update Date | 2012-04-17 |