| NPI | 1104940113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT17881) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH 12225) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2012-07-25 |