| NPI | 1962621946 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: NY 008169-1) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: NY 0081691-1) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: NY 008169-1) | |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2007-07-08 |