| NPI | 1932612520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501018218) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1263115) |
| Enumeration Date | 2017-11-06 |
| Last Update Date | 2017-11-06 |