| NPI | 1023448008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501016130) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1225478) |
| Enumeration Date | 2013-11-12 |
| Last Update Date | 2014-11-25 |