| NPI | 1104954544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NY x003211 DUP) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NJ 1672) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2022-07-19 |