| NPI | 1174047708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 008282) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501017648) |
| Enumeration Date | 2017-07-26 |
| Last Update Date | 2021-09-22 |