| NPI | 1821590480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501002646) |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225100000X Physical Therapist (Licence: 5501002646) | |
| Enumeration Date | 2018-02-28 |
| Last Update Date | 2021-03-31 |