| NPI | 1619913076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 222Q00000X Developmental Therapist (Licence: FL PT0002911) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PTOOO2911) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2011-02-15 |