| NPI | 1972905107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT-4163) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY PT-000636) |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2014-09-18 |