| NPI | 1487927448 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT011004)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 034534)  | 
| 2251P0200X Physical Therapist, Pediatrics | |
| Enumeration Date | 2012-02-21 | 
| Last Update Date | 2022-10-04 |