| NPI | 1891143525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT015114) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WV PT003596) |
| Enumeration Date | 2016-06-03 |
| Last Update Date | 2019-07-10 |