| NPI | 1770118408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501019622) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 298148) |
| Enumeration Date | 2020-03-03 |
| Last Update Date | 2020-07-24 |