| NPI | 1992463707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: LA PGY088993) |
| Additional Taxonomies | 111NX0100X Chiropractor, Occupational Health (Licence: LA 111223) |
| 111NX0100X Chiropractor, Occupational Health (Licence: TX 11112223) | |
| 246RP1900X Technician, Pathology, Phlebotomy | |
| 261QP0905X Clinic/Center, Public Health, State or Local | |
| Enumeration Date | 2021-11-30 |
| Last Update Date | 2023-06-28 |