| NPI | 1396176558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 12432-24) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501016319) |
| Enumeration Date | 2013-12-12 |
| Last Update Date | 2013-12-15 |