| NPI | 1417194655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 24460) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501009596) |
| 225100000X Physical Therapist (Licence: NY 036196-1) | |
| Enumeration Date | 2009-01-09 |
| Last Update Date | 2013-06-08 |