| NPI | 1962772889 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 30712) |
| Additional Taxonomies | 2251P0200X Physical Therapist Pediatrics (Licence: NY 034620-1) |
| Enumeration Date | 2012-01-09 |
| Last Update Date | 2020-05-23 |