| NPI | 1124269337 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist Pediatrics (Licence: NY 021066) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 021066) |
| Enumeration Date | 2009-03-18 |
| Last Update Date | 2009-03-18 |