| NPI | 1528338076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 00951) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501014835) |
| Enumeration Date | 2011-12-30 |
| Last Update Date | 2011-12-30 |