| NPI | 1124577671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 12526) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501017676) |
| Enumeration Date | 2016-09-26 |
| Last Update Date | 2016-09-26 |