| NPI | 1194910497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2007012508) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501012664) |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2007-09-10 |