| NPI | 1407834484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 10802) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: NY 010802-1) |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2023-10-25 |