| NPI | 1477832434 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251G0304X Physical Therapist, Geriatrics (Licence: MD 28402) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT26624) |
| 225100000X Physical Therapist (Licence: VA 2305207054) | |
| Enumeration Date | 2011-08-09 |
| Last Update Date | 2022-01-23 |