| 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 |