| NPI | 1770774879 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: NY x005167)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 003651-1)  | 
| Enumeration Date | 2007-08-05 | 
| Last Update Date | 2007-08-05 |