| NPI | 1710102108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WV 910) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH 005285) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2007-07-08 |