| NPI | 1902947971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT.008519) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OH AT-000256) |
| Enumeration Date | 2007-02-10 |
| Last Update Date | 2018-08-24 |