| NPI | 1598753402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AZ 8576) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NY X009042) |
| 124Q00000X Dental Hygienist (Licence: NY 018540) | |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2021-03-17 |