| NPI | 1710497623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist, Sports (Licence: OH PT017189) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: KY 007248) |
| Enumeration Date | 2017-10-05 |
| Last Update Date | 2024-01-23 |