| NPI | 1104422971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT016416) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT35981) |
| Enumeration Date | 2020-12-08 |
| Last Update Date | 2023-07-12 |