| NPI | 1902190556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: NC 13900) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 23454) |
| Enumeration Date | 2011-05-31 |
| Last Update Date | 2015-03-12 |