| NPI | 1992462147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501301737) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2021-11-23 |
| Last Update Date | 2023-02-01 |