| NPI | 1972904761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501016738) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070.020738) |
| Enumeration Date | 2014-09-11 |
| Last Update Date | 2015-03-30 |