| NPI | 1700365343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501019410) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2018028470) |
| Enumeration Date | 2018-08-13 |
| Last Update Date | 2021-05-14 |