| NPI | 1073804993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 34254) |
| 225100000X Physical Therapist (Licence: MI 5501012812) | |
| Enumeration Date | 2011-04-26 |
| Last Update Date | 2022-03-21 |