| NPI | 1053620336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SD 1926) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501015316) |
| Enumeration Date | 2010-10-04 |
| Last Update Date | 2022-07-21 |