| NPI | 1861977530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 62970) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501018836) |
| Enumeration Date | 2018-09-28 |
| Last Update Date | 2018-09-28 |