| 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 |