| NPI | 1366761132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DE J10002755) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501015156) |
| 2251G0304X Physical Therapist, Geriatrics (Licence: DE J10002755) | |
| Enumeration Date | 2010-05-19 |
| Last Update Date | 2019-04-19 |