| NPI | 1407979404 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251G0304X Physical Therapist, Geriatrics (Licence: WV PT 002939) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT 20800) |
| 2251G0304X Physical Therapist, Geriatrics (Licence: LA 07435R) | |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2014-05-05 |