| NPI | 1588645725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT015414) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH 09919) |
| Enumeration Date | 2005-11-05 |
| Last Update Date | 2012-02-17 |