| NPI | 1235496027 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501017835) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070-019024) |
| 2251S0007X Physical Therapist, Sports (Licence: OH PT016642) | |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2020-08-05 |