NPI | 1922069699 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: NY X012138-1) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: MN 4498) |
Enumeration Date | 2006-03-31 |
Last Update Date | 2020-10-21 |