| NPI | 1700215746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501009943) |
| Additional Taxonomies | 222Q00000X Developmental Therapist (Licence: MI 5501009943) |
| 2251G0304X Physical Therapist, Geriatrics (Licence: MI 5501009943) | |
| Enumeration Date | 2013-11-08 |
| Last Update Date | 2013-11-08 |