| NPI | 1902387673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT017635) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 63406) |
| Enumeration Date | 2018-08-22 |
| Last Update Date | 2019-09-06 |