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 |