| NPI | 1063802528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01595700) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT024070) |
| Enumeration Date | 2015-02-04 |
| Last Update Date | 2015-02-04 |