| NPI | 1679044119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AL 55594) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501018163) |
| Enumeration Date | 2018-12-10 |
| Last Update Date | 2022-01-17 |