| NPI | 1982105805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501015702) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 12202) |
| Enumeration Date | 2018-02-26 |
| Last Update Date | 2020-10-04 |