| NPI | 1508854316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01144200) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ 40Qa01144200) |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2017-01-19 |