| NPI | 1275193658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT018100) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT027728) |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2020-11-16 |