| NPI | 1366817090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501019996) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MI 5502004713) |
| Enumeration Date | 2015-12-07 |
| Last Update Date | 2021-12-28 |