| NPI | 1679845432 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT4463) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| 2251P0200X Physical Therapist, Pediatrics (Licence: FL pt4463) | |
| Enumeration Date | 2012-02-08 |
| Last Update Date | 2019-03-13 |