| NPI | 1245863141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501303860) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MI 5502005861) |
| Enumeration Date | 2020-02-19 |
| Last Update Date | 2025-04-02 |