| NPI | 1598795338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501009797) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI 5501009797) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2021-02-17 |