| NPI | 1639628191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT012438) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: PT012438) |
| Enumeration Date | 2016-09-26 |
| Last Update Date | 2019-08-16 |