| NPI | 1346488681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 007034) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 010608-1) |
| 2251P0200X Physical Therapist, Pediatrics (Licence: CT 007034) | |
| 2251P0200X Physical Therapist, Pediatrics (Licence: NY 010608-1) | |
| Enumeration Date | 2009-01-24 |
| Last Update Date | 2016-06-16 |