| NPI | 1073236063 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501302141)  | 
| Additional Taxonomies | 225100000X Physical Therapist | 
| Enumeration Date | 2022-09-23 | 
| Last Update Date | 2024-08-01 |