| NPI | 1417292780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01698700) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT021018) |
| Enumeration Date | 2012-11-27 |
| Last Update Date | 2016-10-26 |