| NPI | 1700539616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2021049877) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH 019576) |
| Enumeration Date | 2022-01-31 |
| Last Update Date | 2022-01-31 |