| NPI | 1821017542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT26749) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501010350) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2011-10-11 |