| NPI | 1669628681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 10999-24) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501015683) |
| Enumeration Date | 2008-08-10 |
| Last Update Date | 2011-09-30 |