| NPI | 1124103908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0016599) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH PT003129) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2024-05-16 |