| NPI | 1083993620 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA00874800) | 
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: NJ 40QA00874800) | 
| Enumeration Date | 2011-08-14 | 
| Last Update Date | 2014-02-25 |