| NPI | 1467933010 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1299080) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501012262) | 
| Enumeration Date | 2018-08-22 | 
| Last Update Date | 2019-02-25 |