| NPI | 1649885567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist Pediatrics (Licence: NY 8305-1) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 8305-1) |
| Enumeration Date | 2020-09-09 |
| Last Update Date | 2020-09-09 |