| NPI | 1861453615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 3875) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT005606) |
| 2251P0200X Physical Therapist, Pediatrics (Licence: GA PT005606) | |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2021-05-27 |