| NPI | 1891934071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: CO 6369) |
| Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician (Licence: WI 2615-012) |
| 111NS0005X Chiropractor, Sports Physician (Licence: MT 1173) | |
| Enumeration Date | 2009-02-12 |
| Last Update Date | 2011-03-19 |