| NPI | 1912120346 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501003995) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2018-09-19 |