| NPI | 1619065596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P16594) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501010799) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2019-03-04 |