| NPI | 1376871418 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 20418) |
| Additional Taxonomies | 222Q00000X Developmental Therapist (Licence: FL PT20418) |
| Enumeration Date | 2009-12-01 |
| Last Update Date | 2020-02-25 |