| NPI | 1699275396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT016495) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 13375) |
| Enumeration Date | 2018-02-19 |
| Last Update Date | 2019-07-31 |