| NPI | 1639218050 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501001445) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: MI 5501001445) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2007-07-08 |