| NPI | 1710633003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-32889) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501020245) |
| Enumeration Date | 2022-02-24 |
| Last Update Date | 2023-06-21 |