| NPI | 1811693211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: MI 5501302399) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2023-02-07 |
| Last Update Date | 2025-08-04 |