| NPI | 1578883708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 6018) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501013954) |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2010-06-10 |