| NPI | 1215115043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 23848) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH 10854) |
| Enumeration Date | 2008-02-04 |
| Last Update Date | 2008-09-08 |