| NPI | 1508498700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 4703038740) |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2020-02-06 |
| Last Update Date | 2020-02-06 |