| NPI | 1063509867 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: NY X008088) |
| Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician (Licence: NY 3164) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2021-12-15 |