| NPI | 1619935517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038.007113) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038-007113) |
| 111N00000X Chiropractor (Licence: MA 1759) | |
| 111NS0005X Chiropractor, Sports Physician (Licence: IL Cert. # 2865) | |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2022-07-21 |