| NPI | 1760756639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT 25837) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501009944) |
| Enumeration Date | 2012-02-23 |
| Last Update Date | 2012-02-23 |