| NPI | 1518341650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501016863) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1257253) |
| Enumeration Date | 2015-07-18 |
| Last Update Date | 2015-07-18 |