| NPI | 1912175878 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IA 04927) |
| Additional Taxonomies | 111NR0400X (Licence: NE 000972) |
| 111NR0400X (Licence: IA 004927) | |
| 111N00000X Chiropractor (Licence: NE 000972) | |
| Enumeration Date | 2008-02-13 |
| Last Update Date | 2013-10-21 |