| NPI | 1609194927 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: FL PT12809) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2011-10-28 |