| NPI | 1669968533 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305212688) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH PT017506) |
| Enumeration Date | 2018-07-03 |
| Last Update Date | 2019-12-02 |