| NPI | 1982754917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0014547) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501012233) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2023-05-12 |