| NPI | 1467659466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501013764) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY PT-005125) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2021-06-24 |