| NPI | 1578229258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501019518) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1274367) |
| Enumeration Date | 2021-11-16 |
| Last Update Date | 2021-11-16 |