| NPI | 1982152526 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT018451) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 22625) |
| Enumeration Date | 2016-09-12 |
| Last Update Date | 2020-07-06 |