NPI | 1699807149 |
---|---|
Entity Type | Individual |
Gender | N/A |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: FL 41549) |
Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: NY 009469-1) |
Enumeration Date | 2007-03-11 |
Last Update Date | 2024-11-03 |