| NPI | 1073119814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501019743) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 046561) |
| Enumeration Date | 2020-12-08 |
| Last Update Date | 2021-04-30 |