| NPI | 1215139845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT005826) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501006642) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2008-09-02 |