| NPI | 1912320409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NY 012546) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NJ 38MC00714900) |
| Enumeration Date | 2014-02-04 |
| Last Update Date | 2017-10-04 |