| NPI | 1386156149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501019534) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 007286) |
| Enumeration Date | 2017-11-01 |
| Last Update Date | 2022-07-08 |