| NPI | 1417238809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501016240) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: CA PTLA) |
| Enumeration Date | 2011-08-30 |
| Last Update Date | 2020-01-13 |