| NPI | 1679107544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT017981) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 302129) |
| 2251G0304X Physical Therapist, Geriatrics (Licence: FL 35615) | |
| Enumeration Date | 2020-02-28 |
| Last Update Date | 2025-09-11 |