| NPI | 1295072577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501016105) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT021128) |
| Enumeration Date | 2013-01-07 |
| Last Update Date | 2013-01-07 |