| NPI | 1609305556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist, Sports (Licence: KY 007238) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: OH PT016954) |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2022-03-22 |