| NPI | 1396392171 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 16265-24) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501019250) |
| Enumeration Date | 2019-08-26 |
| Last Update Date | 2023-06-06 |