| NPI | 1679804926 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 291187) |
| Additional Taxonomies | 222Q00000X Developmental Therapist (Licence: FL PT25184) |
| 225100000X Physical Therapist (Licence: TX 1193849) | |
| 2251P0200X Physical Therapist, Pediatrics (Licence: FL PT25184) | |
| Enumeration Date | 2010-01-27 |
| Last Update Date | 2019-02-01 |