| NPI | 1629348461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist Orthopedic (Licence: OR 60365) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501015794) |
| Enumeration Date | 2012-01-11 |
| Last Update Date | 2016-02-17 |