| NPI | 1962942318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501017632) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH PT016258) |
| Enumeration Date | 2017-03-05 |
| Last Update Date | 2017-03-05 |