| NPI | 1205969920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251G0304X Physical Therapist, Geriatrics (Licence: CA 36701) |
| Additional Taxonomies | 171W00000X Contractor (Licence: NY 0289711) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2021-03-03 |