| NPI | 1679853980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 10132) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501011365) |
| Enumeration Date | 2011-08-18 |
| Last Update Date | 2014-06-20 |