| NPI | 1417404310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: NY 040657) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 040657) |
| Enumeration Date | 2016-09-08 |
| Last Update Date | 2025-02-24 |