| NPI | 1528467719 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 31353) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 034166) | 
| 2251P0200X Physical Therapist, Pediatrics (Licence: NY 034166) | |
| 2251P0200X Physical Therapist, Pediatrics | |
| Enumeration Date | 2014-08-14 | 
| Last Update Date | 2025-05-21 |