NPI | 1528467719 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 034166) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 31353) |
2251P0200X Physical Therapist, Pediatrics (Licence: NY 034166) | |
Enumeration Date | 2014-08-14 |
Last Update Date | 2021-02-12 |