| NPI | 1558505214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DC PT871011) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501014363) |
| 225100000X Physical Therapist (Licence: NY 030405) | |
| Enumeration Date | 2009-04-26 |
| Last Update Date | 2009-04-26 |