| NPI | 1922088145 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2251G0304X Physical Therapist, Geriatrics (Licence: IA 00734) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 00734) | 
| 225100000X Physical Therapist (Licence: MN 8612) | |
| Enumeration Date | 2006-01-23 | 
| Last Update Date | 2011-05-23 |