| NPI | 1376954230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501010969) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 886) |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2016-03-22 |