| NPI | 1578993846 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501019025) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MI 5502002995) |
| Enumeration Date | 2013-11-22 |
| Last Update Date | 2019-01-08 |