| NPI | 1003515701 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NH EL11339) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH PT020266) |
| Enumeration Date | 2023-03-01 |
| Last Update Date | 2023-03-01 |