| NPI | 1518211697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05011733A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 12214-24) |
| 225100000X Physical Therapist (Licence: OH PT.014010) | |
| Enumeration Date | 2012-10-29 |
| Last Update Date | 2019-12-09 |