| NPI | 1326275553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251G0304X Physical Therapist Geriatrics (Licence: WA 60320009) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: CO 10407) |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2024-05-07 |