| NPI | 1164424842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT012155L) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA00968000) |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2007-07-08 |