| NPI | 1326132317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 6812) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC 10811) |
| 225100000X Physical Therapist (Licence: MI 5501014903) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2015-11-06 |