| NPI | 1164483756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT006001L) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01151700) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2011-09-23 |