| NPI | 1629160734 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT011791) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501012448) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2015-01-20 |