| NPI | 1841997392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501302452) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 17162) |
| Enumeration Date | 2023-02-14 |
| Last Update Date | 2026-04-15 |