| NPI | 1518990746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT009012) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: LA 05000) |
| 2251G0304X Physical Therapist Geriatrics (Licence: LA 05000) | |
| 2251S0007X Physical Therapist Sports (Licence: LA 05000) | |
| 2251X0800X Physical Therapist Orthopedic (Licence: LA 05000) | |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2008-03-24 |