| NPI | 1114245644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: NY 015058-1) |
| Additional Taxonomies | 2251C2600X (Licence: NY 015058-1) |
| Enumeration Date | 2010-05-07 |
| Last Update Date | 2010-05-07 |