| NPI | 1255418778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT 09814) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY PT 004181) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2007-11-02 |