| NPI | 1598217044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NV 4711) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501005528) |
| Enumeration Date | 2016-11-01 |
| Last Update Date | 2023-03-15 |