| NPI | 1386229615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501019093) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ LPT-013399) |
| Enumeration Date | 2021-03-17 |
| Last Update Date | 2021-03-17 |