| NPI | 1245502491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AR PT3178) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501014005) |
| Enumeration Date | 2012-02-03 |
| Last Update Date | 2012-02-03 |