| NPI | 1184826539 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 174400000X Specialist (Licence: OH 1259) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH 1259) | 
| Enumeration Date | 2007-06-05 | 
| Last Update Date | 2024-11-26 |