| NPI | 1124315023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 11576) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501015539) |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2019-06-25 |