| NPI | 1912025727 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: GA CHIRO06390) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 57858) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2008-03-28 |