| NPI | 1902054455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT24241) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: FL OT12720) |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2008-09-08 |