| NPI | 1013556976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI PENDING) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH PT018235) |
| Enumeration Date | 2019-12-24 |
| Last Update Date | 2022-06-09 |