| NPI | 1679925986 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501302335) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MI 5502003562) |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2025-04-25 |