| NPI | 1346958774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501303443) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 049641-01) |
| Enumeration Date | 2022-11-15 |
| Last Update Date | 2024-08-23 |