| NPI | 1093923070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ND 973) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 5574) |
| 225100000X Physical Therapist (Licence: CA 14080) | |
| 225100000X Physical Therapist (Licence: MI 5501003202) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2007-07-08 |