| NPI | 1770798746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501006142) |
| Additional Taxonomies | 246QM0706X Spec/Tech, Pathology, Medical Technologist (Licence: MI 172155) |
| Enumeration Date | 2007-05-13 |
| Last Update Date | 2007-07-08 |