| NPI | 1205030814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: CT 001249) |
| Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician (Licence: NY 008848) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2007-07-08 |