| NPI | 1336208875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501012263) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 11375) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2013-10-03 |