| NPI | 1841864311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant |
| Additional Taxonomies | 261QP2000X Clinic/Center Physical Therapy (Licence: MI 5502003149) |
| Enumeration Date | 2021-05-18 |
| Last Update Date | 2021-05-18 |