| NPI | 1285151571 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501018521) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 11302) |
| Enumeration Date | 2017-08-28 |
| Last Update Date | 2020-12-22 |