NPI | 1336132554 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: FL H6649) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NJ Inactive status) |
111N00000X Chiropractor (Licence: AL 1509) | |
Enumeration Date | 2005-08-23 |
Last Update Date | 2015-09-15 |