| NPI | 1336446947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501015780) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 031072) |
| Enumeration Date | 2011-02-16 |
| Last Update Date | 2013-07-18 |