| NPI | 1205147014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 026143) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: NY 026143-1) |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2021-08-12 |