| NPI | 1255672879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501016178) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 7231) |
| 225100000X Physical Therapist (Licence: LA 10227R) | |
| Enumeration Date | 2013-03-06 |
| Last Update Date | 2023-03-27 |