| NPI | 1700324035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501301870) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0014521) |
| Enumeration Date | 2017-02-07 |
| Last Update Date | 2023-04-06 |