| NPI | 1962142208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-32381) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH PT019639) |
| Enumeration Date | 2022-04-01 |
| Last Update Date | 2023-10-31 |