| NPI | 1245610930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 09607R) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: LA 09607R) |
| 310400000X Assisted Living Facility (Licence: OR 61112) | |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2023-06-26 |