| NPI | 1215320783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251E1300X Physical Therapist, Electrophysiology, Clinical (Licence: MI 5501008847) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501008847) |
| Enumeration Date | 2015-03-09 |
| Last Update Date | 2018-05-31 |