| NPI | 1699771899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT006269) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: GA ATC020202200) |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2015-10-07 |