| NPI | 1295790467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 2251S0007X Physical Therapist Sports (Licence: NJ 40QB00028400) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: NJ 40QB00028400) |
| 225200000X Physical Therapy Assistant (Licence: NJ 40QB00028400) | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2007-07-08 |