| NPI | 1770603698 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501020149) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2021-09-10 |