| NPI | 1578063244 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501018029) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 55010180299) |
| Enumeration Date | 2018-02-19 |
| Last Update Date | 2025-09-12 |