| NPI | 1629548029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT295719) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501016994) |
| Enumeration Date | 2018-11-28 |
| Last Update Date | 2019-09-05 |