| NPI | 1720360282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305216347) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501015185) |
| Enumeration Date | 2011-09-12 |
| Last Update Date | 2025-01-23 |