| NPI | 1881895712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501011046) |
| Additional Taxonomies | 171W00000X Contractor (Licence: MI 5501011046) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2017-05-24 |