| NPI | 1275706137 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 3584 - 024) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501005312) |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2012-09-28 |