| 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: NJ 40QA02159600) |
| 225100000X Physical Therapist (Licence: NY 0308101) | |
| Enumeration Date | 2010-07-14 |
| Last Update Date | 2024-10-29 |