| NPI | 1639134125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 8222) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501010444) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2015-09-04 |