| NPI | 1063631570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 11359) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501008634) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2023-09-07 |