| NPI | 1295004141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 550104043) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 35810) |
| 225100000X Physical Therapist (Licence: NC P13504) | |
| Enumeration Date | 2011-12-22 |
| Last Update Date | 2018-08-17 |