| NPI | 1063636496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT19729) |
| Additional Taxonomies | 225000000X Orthotic Fitter |
| 225100000X Physical Therapist (Licence: VA 2305204603) | |
| 222Q00000X Developmental Therapist (Licence: FL PT19729) | |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2016-06-06 |