| NPI | 1952934648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL PTA29856) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: FL PTA29856) |
| 208100000X Physical Medicine & Rehabilitation (Licence: FL PTA29856) | |
| Enumeration Date | 2020-02-20 |
| Last Update Date | 2026-02-16 |