| NPI | 1477950962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 60790) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501016965) |
| Enumeration Date | 2014-11-26 |
| Last Update Date | 2018-08-13 |