| NPI | 1861805749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT 29234) |
| Additional Taxonomies | 222Q00000X Developmental Therapist (Licence: FL PT 29234) |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2014-06-23 |