| NPI | 1679725857 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 12816)  | 
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: NY 013324)  | 
| Enumeration Date | 2008-10-19 | 
| Last Update Date | 2025-07-22 |