| NPI | 1083171094 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AZ 9409)  | 
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: AZ ATR-100156)  | 
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT005583)  | |
| Enumeration Date | 2019-02-26 | 
| Last Update Date | 2024-12-09 |