| NPI | 1871986604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 9594) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH PT.015210) |
| Enumeration Date | 2015-03-18 |
| Last Update Date | 2015-03-18 |