| NPI | 1366871345 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 24741) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH PT.014508) |
| 225100000X Physical Therapist (Licence: PA PT023161) | |
| Enumeration Date | 2013-11-11 |
| Last Update Date | 2019-10-17 |