| NPI | 1184975567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT020191) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PA PT022280) |
| 225100000X Physical Therapist (Licence: MT 12846) | |
| Enumeration Date | 2012-09-26 |
| Last Update Date | 2023-03-10 |