| NPI | 1679051585 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT34770) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501018614) |
| 225100000X Physical Therapist | |
| Enumeration Date | 2018-08-02 |
| Last Update Date | 2019-08-05 |