| NPI | 1164053815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT018261) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 298007) |
| Enumeration Date | 2020-01-31 |
| Last Update Date | 2020-10-23 |