| NPI | 1962062273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501019193) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 27377) |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2021-04-07 |