NPI | 1689608788 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: WI 5127-12) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT003760) |
Enumeration Date | 2006-07-11 |
Last Update Date | 2015-11-11 |