| NPI | 1992789226 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501003185) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 15456) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2011-05-10 |