| NPI | 1164719308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: NY 039868) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: VA 2305206985) |
| Enumeration Date | 2011-07-08 |
| Last Update Date | 2016-01-12 |