| NPI | 1548702095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MI 5502005102) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| Enumeration Date | 2016-11-15 |
| Last Update Date | 2019-10-03 |