| NPI | 1790921336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: VA 2305206427) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: NY 030187) |
| Enumeration Date | 2009-01-04 |
| Last Update Date | 2020-03-01 |