| NPI | 1770781536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501015556) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 5423) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2011-07-13 |