| NPI | 1154472231 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT28177) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| 225100000X Physical Therapist (Licence: TX 1140200) | |
| 2251P0200X Physical Therapist, Pediatrics (Licence: FL PT28177) | |
| 2251P0200X Physical Therapist, Pediatrics (Licence: TX 1140200) | |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2021-03-31 |