| NPI | 1053545103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501011895) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DC PT87087) |
| Enumeration Date | 2009-05-04 |
| Last Update Date | 2009-05-04 |