| NPI | 1740265966 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 111N00000X Chiropractor (Licence: SC 3096) | 
| Additional Taxonomies | 111N00000X Chiropractor (Licence: PA DC8659) | 
| Enumeration Date | 2005-12-09 | 
| Last Update Date | 2012-03-19 |