| NPI | 1962903294 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501010993) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05007396A) |
| Enumeration Date | 2018-02-22 |
| Last Update Date | 2018-03-17 |