| NPI | 1962534701 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501012344) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 18052) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2018-03-20 |