| NPI | 1821341181 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501003076) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: HI PT3563) |
| Enumeration Date | 2012-10-23 |
| Last Update Date | 2012-10-23 |