| NPI | 1902044167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: NY 030997-1) |
| Additional Taxonomies | 2251G0304X Physical Therapist, Geriatrics (Licence: NY 030997-1) |
| Enumeration Date | 2009-01-27 |
| Last Update Date | 2009-07-15 |