| NPI | 1750522553 |
|---|---|
| Former Name | SHIRA ANN DIXON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT009555) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: GA 030702136) |
| Enumeration Date | 2009-03-09 |
| Last Update Date | 2020-09-18 |