| NPI | 1083715619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501011269) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI L742129) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2012-11-16 |