| NPI | 1205936739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT 0003085) |
| Additional Taxonomies | 222Q00000X Developmental Therapist (Licence: FL PT3085) |
| Enumeration Date | 2006-09-24 |
| Last Update Date | 2011-03-16 |