| NPI | 1194808709 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL pt7804) |
| Additional Taxonomies | 222Q00000X Developmental Therapist (Licence: FL PT7804) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2011-05-31 |