| NPI | 1417609264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501301887) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 12746) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: PA PT031688) | |
| Enumeration Date | 2022-01-24 |
| Last Update Date | 2024-01-10 |