| NPI | 1083967996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501016051) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 034869) |
| Enumeration Date | 2012-10-17 |
| Last Update Date | 2012-10-17 |