| NPI | 1174068555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501017168) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 25894) |
| Enumeration Date | 2016-12-21 |
| Last Update Date | 2019-10-11 |