| NPI | 1518523653 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: NY 026358-1)  | 
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: TN 7467)  | 
| Enumeration Date | 2019-05-14 | 
| Last Update Date | 2019-05-14 |