| NPI | 1508877655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: NJ PT40QA01043200) |
| 2251X0800X Physical Therapist, Orthopedic | |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2007-12-12 |