NPI | 1619195518 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: NY 023745) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01113400) |
Enumeration Date | 2007-04-23 |
Last Update Date | 2012-05-27 |