| NPI | 1770719197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1191605) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501013541) |
| Enumeration Date | 2009-06-01 |
| Last Update Date | 2022-05-09 |