| NPI | 1790063725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501003156) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH 003984) |
| Enumeration Date | 2011-07-25 |
| Last Update Date | 2022-04-15 |