| NPI | 1497164883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT.014594) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WV PT003301) |
| Enumeration Date | 2014-08-11 |
| Last Update Date | 2019-11-22 |