NPI | 1053648352 |
---|---|
Former Name | CHRISTINE ANNE LAGE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA1593500) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 8683) |
Enumeration Date | 2009-11-06 |
Last Update Date | 2015-01-19 |