| NPI | 1649606294 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501007126) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 2286-24) |
| Enumeration Date | 2013-09-15 |
| Last Update Date | 2013-09-15 |