NPI | 1679065379 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: MI 5501010706) |
Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: MI 5501010706) |
Enumeration Date | 2018-05-30 |
Last Update Date | 2018-05-30 |