| NPI | 1043608193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT29979) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2014-12-23 |
| Last Update Date | 2016-08-22 |