| NPI | 1154676617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT010114) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH PT.013713) |
| Enumeration Date | 2012-07-19 |
| Last Update Date | 2012-07-19 |