| NPI | 1790140895 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT-27995)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: HI PT-4031)  | 
| 225X00000X Occupational Therapist (Licence: HI OT-1268)  | |
| 225X00000X Occupational Therapist (Licence: FL OT14765)  | |
| Enumeration Date | 2015-12-16 | 
| Last Update Date | 2021-07-11 |