| NPI | 1659600971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501020010) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 28676) |
| Enumeration Date | 2009-12-15 |
| Last Update Date | 2023-01-20 |