| NPI | 1518508753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501019612) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 14691) |
| Enumeration Date | 2019-09-30 |
| Last Update Date | 2020-09-15 |