| NPI | 1639467418 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT017779) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 26460) |
| Enumeration Date | 2011-07-14 |
| Last Update Date | 2026-01-05 |