| NPI | 1679062202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MI 5501007046) |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2018-05-09 |