| NPI | 1861686750 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501300654) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 8535) |
| Enumeration Date | 2007-09-04 |
| Last Update Date | 2015-09-12 |