| NPI | 1578075115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501019550) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 13142) |
| Enumeration Date | 2017-11-03 |
| Last Update Date | 2025-11-19 |