| NPI | 1588175004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501019392) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 8986) |
| Enumeration Date | 2017-10-24 |
| Last Update Date | 2020-02-25 |