| NPI | 1760636245 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 28740) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 0094751) |
| 2251P0200X Physical Therapist, Pediatrics (Licence: NY 0094751) | |
| Enumeration Date | 2008-11-10 |
| Last Update Date | 2015-03-30 |