| NPI | 1669762464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P15703) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501014661) |
| 225100000X Physical Therapist (Licence: SC CP025062T) | |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2025-01-08 |