| NPI | 1013115484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT9091) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: GA AT001287) |
| Enumeration Date | 2007-07-06 |
| Last Update Date | 2011-01-26 |