| NPI | 1912677766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MO 2024023654) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CO CHR.0008312) |
| Enumeration Date | 2021-09-14 |
| Last Update Date | 2025-10-16 |