| NPI | 1053500173 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501004528) |
| Enumeration Date | 2007-10-15 |
| Last Update Date | 2023-01-31 |