| NPI | 1396253399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA PTL23890) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501018537) |
| Enumeration Date | 2018-01-12 |
| Last Update Date | 2025-10-14 |