| NPI | 1003117748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1323107) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MI 5502001711) |
| 225200000X Physical Therapy Assistant (Licence: TX 22077702) | |
| Enumeration Date | 2010-11-11 |
| Last Update Date | 2022-03-20 |