| NPI | 1962667733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 033472-1) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501013862) |
| Enumeration Date | 2008-07-22 |
| Last Update Date | 2016-04-06 |