| NPI | 1164888012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT003038) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501017551) |
| Enumeration Date | 2016-01-07 |
| Last Update Date | 2022-07-21 |