| NPI | 1902232150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT012735) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 12454-24) |
| Enumeration Date | 2013-09-19 |
| Last Update Date | 2020-02-19 |