| NPI | 1306112495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 19644) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501015575) |
| 225100000X Physical Therapist (Licence: CA 39725) | |
| Enumeration Date | 2012-03-22 |
| Last Update Date | 2013-09-26 |