| NPI | 1902167687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MI 2301010184) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MO 2012015868) |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2014-02-11 |