| NPI | 1063022747 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT36095) |
| Additional Taxonomies | 222Q00000X Developmental Therapist (Licence: FL PT36095) |
| Enumeration Date | 2020-08-06 |
| Last Update Date | 2025-11-30 |