| NPI | 1750759874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501302334) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OH TX948229) |
| Enumeration Date | 2015-09-04 |
| Last Update Date | 2022-11-08 |