| NPI | 1609496520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501301818) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ME PT5565) |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2022-01-10 |