| NPI | 1336321934 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: NY 029730) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 029730) |
| 2251P0200X Physical Therapist Pediatrics (Licence: NY 029730) | |
| Enumeration Date | 2007-12-05 |
| Last Update Date | 2021-01-28 |