| NPI | 1548662679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251G0304X Physical Therapist, Geriatrics (Licence: GA 11632) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501015228) |
| Enumeration Date | 2014-09-19 |
| Last Update Date | 2014-09-19 |