| NPI | 1083733612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MD 02169) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: VA 0104556067) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2007-07-08 |