| NPI | 1316573603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501018766) |
| Enumeration Date | 2020-03-18 |
| Last Update Date | 2026-06-22 |