| NPI | 1558765453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05011586A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501016901) |
| Enumeration Date | 2014-10-21 |
| Last Update Date | 2014-10-21 |