| NPI | 1316292758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT014515) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT022182) |
| Enumeration Date | 2012-07-23 |
| Last Update Date | 2016-03-22 |