| NPI | 1285233007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: KS N040004) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: KS 14-03764) |
| Enumeration Date | 2020-10-22 |
| Last Update Date | 2020-11-10 |