| NPI | 1356719504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501017365) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MI 5201009162) |
| Enumeration Date | 2015-09-04 |
| Last Update Date | 2022-01-24 |