| NPI | 1003464702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501303424) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 044493) |
| Enumeration Date | 2019-08-27 |
| Last Update Date | 2025-01-06 |