| NPI | 1972194769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor Sports Physician (Licence: OR 6132) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: OR 6132) |
| Enumeration Date | 2021-02-03 |
| Last Update Date | 2021-02-03 |