| NPI | 1215169594 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01394600) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305206092) |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2011-08-22 |