| NPI | 1932692464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501302508) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MI 5502005620) |
| Enumeration Date | 2018-06-09 |
| Last Update Date | 2023-03-29 |