| NPI | 1336891183 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: GA PT015743) | 
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: GA PT015743) | 
| Enumeration Date | 2022-01-24 | 
| Last Update Date | 2025-05-28 |