| NPI | 1114315256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501016157) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 9502) |
| 225100000X Physical Therapist | |
| Enumeration Date | 2014-12-23 |
| Last Update Date | 2019-06-03 |