| NPI | 1992161194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT 30996) |
| Additional Taxonomies | 222Q00000X Developmental Therapist (Licence: FL PT 30996) |
| Enumeration Date | 2016-01-05 |
| Last Update Date | 2019-08-01 |