| NPI | 1164561122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 023989) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 17712) |
| 2251P0200X Physical Therapist Pediatrics (Licence: NY 029389) | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2011-01-19 |