| NPI | 1629466289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501015453) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0012557) |
| Enumeration Date | 2015-01-06 |
| Last Update Date | 2021-03-24 |