| NPI | 1376543744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PTO07918L) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01152900) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2010-09-23 |