| NPI | 1467887778 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 60542) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH PT.014485) | 
| Enumeration Date | 2013-09-05 | 
| Last Update Date | 2018-04-13 |