| NPI | 1639461668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251G0304X Physical Therapist, Geriatrics (Licence: TX 1229173) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 15302) |
| 225100000X Physical Therapist (Licence: CT 008742) | |
| Enumeration Date | 2011-05-10 |
| Last Update Date | 2016-02-17 |