| NPI | 1154491397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA00781400) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT012020L) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2007-08-31 |