| NPI | 1730682261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501012382) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: MI 5501012382) |
| Enumeration Date | 2018-03-12 |
| Last Update Date | 2018-11-30 |