| NPI | 1811563802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: CA 33618) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 34618) |
| 111NR0200X Chiropractor, Radiology (Licence: CA 00207166) | |
| 111NR0400X (Licence: CA 34618) | |
| Enumeration Date | 2021-06-01 |
| Last Update Date | 2024-12-27 |