| NPI | 1053644930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P13688) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH PT.012148) |
| Enumeration Date | 2009-09-10 |
| Last Update Date | 2020-02-25 |