| NPI | 1790269314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501303324) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH PT017546) |
| Enumeration Date | 2018-09-19 |
| Last Update Date | 2026-01-28 |