| NPI | 1376735969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501013451) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 7911) |
| Enumeration Date | 2007-08-16 |
| Last Update Date | 2007-08-31 |