| NPI | 1457012866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT019959) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ LPT-32148) |
| Enumeration Date | 2022-01-07 |
| Last Update Date | 2024-06-03 |