| NPI | 1508009044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305207668) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501014126) |
| Enumeration Date | 2009-04-14 |
| Last Update Date | 2015-02-18 |