| NPI | 1710050778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT19446) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2011-09-09 |