| NPI | 1538195003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH 008925) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OH 597) |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2013-09-19 |