| NPI | 1730346503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501014537) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 031302) |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2022-07-05 |