| NPI | 1801049028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 026356-1) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: NY 026356-1) |
| Enumeration Date | 2008-10-31 |
| Last Update Date | 2012-06-14 |