| NPI | 1821156514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501002122) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 2232-024) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2007-07-08 |