| NPI | 1598315079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501020203) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID 6513) |
| Enumeration Date | 2019-09-16 |
| Last Update Date | 2022-02-03 |