| NPI | 1790183325 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 14610) |
| Additional Taxonomies | 2251G0304X Physical Therapist, Geriatrics (Licence: NC 14610) |
| Enumeration Date | 2014-12-13 |
| Last Update Date | 2019-09-23 |