| NPI | 1710723242 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT21221) | 
| Additional Taxonomies | 222Q00000X Developmental Therapist | 
| Enumeration Date | 2024-07-03 | 
| Last Update Date | 2024-07-03 |