| NPI | 1447298203 |
|---|---|
| Former Name | DIANE HICKEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA00890200) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT0005702) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2007-07-08 |