| NPI | 1871592899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MN 2105) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WI 2084-012) |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2014-04-02 |