| NPI | 1104825082 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01124400) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT010060L) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2010-08-10 |