| NPI | 1639262793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT27366) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: VA 2305004336) |
| 225100000X Physical Therapist (Licence: VA 2305004336) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2012-06-20 |