| NPI | 1174172571 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501019342) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0018549) |
| Enumeration Date | 2019-09-09 |
| Last Update Date | 2025-05-16 |