| NPI | 1407104672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501005076) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH PT.012303) |
| Enumeration Date | 2012-08-20 |
| Last Update Date | 2012-08-20 |