| NPI | 1891129052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 11201) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501016446) |
| Enumeration Date | 2013-08-23 |
| Last Update Date | 2015-04-20 |