| NPI | 1154561181 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: NY 022114)  | 
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: NJ 40qa01143200)  | 
| Enumeration Date | 2009-03-04 | 
| Last Update Date | 2012-04-12 |