| NPI | 1366880890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501019501) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0013151) |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2020-07-07 |