NPI | 1710265137 |
---|---|
Former Name | LAUREN ELIZABETH SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT010327) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: GA AT001671) |
Enumeration Date | 2011-08-02 |
Last Update Date | 2016-08-29 |