| NPI | 1215452735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1339076) |
| Additional Taxonomies | 2251G0304X Physical Therapist Geriatrics (Licence: CT 6431) |
| 2251G0304X Physical Therapist Geriatrics (Licence: WY 1504) | |
| Enumeration Date | 2017-08-04 |
| Last Update Date | 2021-02-20 |