| NPI | 1598316432 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501301717) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2019-09-23 |
| Last Update Date | 2022-11-10 |