| NPI | 1871719351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: MI 5501012422) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 6974) |
| 225100000X Physical Therapist (Licence: MI 5501012422) | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2014-01-20 |