| NPI | 1023243276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 8021) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501012943) |
| Enumeration Date | 2009-05-18 |
| Last Update Date | 2021-07-30 |