| NPI | 1679029854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT017608) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1280635) |
| Enumeration Date | 2016-08-29 |
| Last Update Date | 2018-12-06 |