| NPI | 1033603857 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501002878) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2018-06-15 |
| Last Update Date | 2018-06-15 |