| NPI | 1619181963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NY x003801-1) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 15773) |
| 111N00000X Chiropractor (Licence: CT 453) | |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2007-07-08 |