| 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 |