| NPI | 1326610734 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501303816) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MN 12220) |
| Enumeration Date | 2021-07-14 |
| Last Update Date | 2025-03-17 |