| NPI | 1679828370 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IL 038.012189) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MO 2012013173) |
| Enumeration Date | 2012-07-18 |
| Last Update Date | 2013-03-04 |