| 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 |