| NPI | 1215006895 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501011676) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0012991) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2025-09-23 |