| NPI | 1225485956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501017959) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VT 040.0119199) |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2019-06-27 |