| NPI | 1760930119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT018807) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| Enumeration Date | 2016-09-14 |
| Last Update Date | 2020-11-23 |