| NPI | 1043505795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA00460300) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ 40QA00460300) |
| Enumeration Date | 2011-06-10 |
| Last Update Date | 2020-01-24 |