| NPI | 1528374915 |
|---|---|
| Former Name | LAUREL OH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 61381) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 36990) |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2020-01-23 |