| NPI | 1972612513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 6659) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 36569) |
| 2251G0304X Physical Therapist, Geriatrics (Licence: FL 6659) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2022-03-10 |