| NPI | 1053381400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT007043) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: GA PT007043) |
| 2251S0007X Physical Therapist, Sports (Licence: GA Pt007043) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: GA PT007043) | |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2019-09-20 |