| NPI | 1912007550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IA 06704) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: AZ 7637) |
| 163W00000X Registered Nurse (Licence: IA 109917) | |
| 163W00000X Registered Nurse (Licence: IL 041-274183) | |
| Enumeration Date | 2006-09-24 |
| Last Update Date | 2008-06-17 |