| NPI | 1215919824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AZ 7022) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NY XOO4949-1) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2016-05-25 |