| NPI | 1467765859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: NY 030810) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 0308101) |
| Enumeration Date | 2010-07-14 |
| Last Update Date | 2021-10-14 |