| NPI | 1619969755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH7707) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: FL PN1047261) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2007-07-08 |