| NPI | 1083592653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501304135) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 17235-24) |
| Enumeration Date | 2025-08-22 |
| Last Update Date | 2026-02-02 |