| NPI | 1114937455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CO CHR-6039) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038-010741) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2007-08-01 |