| NPI | 1689054546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 43110) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501017208) |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2015-10-10 |