| NPI | 1417640129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501302644) |
| Additional Taxonomies | 2251N0400X Physical Therapist, Neurology (Licence: MI 5501302644) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: MI 5501302644) | |
| Enumeration Date | 2023-05-30 |
| Last Update Date | 2023-05-30 |