| NPI | 1730301193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT8748) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2011-12-07 |