| NPI | 1760744742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: KS 14-01616) |
| Additional Taxonomies | 2251G0304X Physical Therapist, Geriatrics (Licence: KS 14-01616) |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2012-06-14 |