| NPI | 1972624757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT 010740) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OH AT001204) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2014-03-19 |