| NPI | 1134736671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501302087) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1338674) |
| Enumeration Date | 2020-09-29 |
| Last Update Date | 2023-06-12 |