| NPI | 1811208135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251G0304X Physical Therapist, Geriatrics (Licence: MA 20155) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VT 040.0066530) |
| 2251G0304X Physical Therapist, Geriatrics (Licence: VT 040.0066530) | |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2019-07-29 |