| NPI | 1013539089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501013370) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1324929) |
| Enumeration Date | 2020-05-13 |
| Last Update Date | 2020-05-13 |