| NPI | 1043582976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501016732) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 6634) |
| Enumeration Date | 2012-02-08 |
| Last Update Date | 2016-03-16 |