| NPI | 1558723643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT012739) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: TX 1268549) |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2020-12-17 |