| NPI | 1992242259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501014881) |
| Enumeration Date | 2017-01-25 |
| Last Update Date | 2024-10-04 |