| NPI | 1174928568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501017013) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2014-10-28 |
| Last Update Date | 2018-03-20 |