| NPI | 1669955092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501018818) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2018-09-11 |
| Last Update Date | 2025-01-30 |