| NPI | 1083371694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OK 115440) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA CP008706T) |
| 2251G0304X Physical Therapist, Geriatrics (Licence: TN 13916) | |
| Enumeration Date | 2021-11-18 |
| Last Update Date | 2023-01-10 |