| NPI | 1073467981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501303826) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: MI 5501303826) |
| Enumeration Date | 2026-02-26 |
| Last Update Date | 2026-02-26 |