| NPI | 1821464207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NR0400X (Licence: SC 4030) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: SC 4030) |
| 111N00000X Chiropractor (Licence: WV 983) | |
| 111N00000X Chiropractor (Licence: NC 4556) | |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2022-04-26 |