| NPI | 1730396235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501009519) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI 551009519) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2018-05-24 |