| NPI | 1265960090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501019389) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MT PTP-PT-LIC-12931) |
| Enumeration Date | 2017-05-24 |
| Last Update Date | 2021-01-08 |