| NPI | 1396002275 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: MI 5501015157) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: TN 1863) |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2012-04-18 |