| NPI | 1679072508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT017933) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501018580) |
| Enumeration Date | 2018-02-06 |
| Last Update Date | 2019-10-16 |