| NPI | 1982838041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT009602) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: GA PT009602) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: GA PT009602) | |
| 2251P0200X Physical Therapist, Pediatrics (Licence: GA PT009602) | |
| Enumeration Date | 2009-05-05 |
| Last Update Date | 2015-12-11 |