| NPI | 1720188642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH 9255) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WV 002012) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2013-08-14 |