| NPI | 1477580785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT008484) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: GA AT001252) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2012-02-28 |