| NPI | 1114262995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251G0304X Physical Therapist, Geriatrics (Licence: TX 8940) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT8940) |
| Enumeration Date | 2012-12-04 |
| Last Update Date | 2015-11-04 |