| NPI | 1740575257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501016529) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2011-06-13 |
| Last Update Date | 2013-11-06 |