| NPI | 1710064159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5201003625) |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2022-03-24 |