| NPI | 1023556727 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501016789) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA 60713599) |
| Enumeration Date | 2017-02-02 |
| Last Update Date | 2022-07-22 |