NPI | 1043302763 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111NX0800X Chiropractor, Orthopedic (Licence: CT 000621) |
Additional Taxonomies | 111NX0800X Chiropractor, Orthopedic (Licence: CA 17369) |
Enumeration Date | 2006-09-29 |
Last Update Date | 2007-07-08 |