| NPI | 1972652410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: PA DC00572L) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: PA DC00572L) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2014-09-30 |