| NPI | 1689725830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501019854) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MA48828) |
| 225100000X Physical Therapist (Licence: FL PT20926) | |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2022-04-06 |