| NPI | 1992790455 |
|---|---|
| Former Name | ELISSA PARKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 025861) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: NY 025861) |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2018-10-08 |