| NPI | 1962920124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: OH PT019267) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH PT019267) |
| 261QP2000X Clinic/Center, Physical Therapy (Licence: IL 070023306) | |
| Enumeration Date | 2017-09-07 |
| Last Update Date | 2025-04-10 |