| NPI | 1104317742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 42053) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501014658) |
| Enumeration Date | 2018-05-18 |
| Last Update Date | 2018-05-18 |