| NPI | 1235681644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501017664) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 038921-1) |
| Enumeration Date | 2016-11-02 |
| Last Update Date | 2018-04-17 |