| NPI | 1477632768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 2401) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501001650) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2007-07-09 |