| NPI | 1609368992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501016194) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2018-06-01 |
| Last Update Date | 2018-06-01 |