| NPI | 1548631005 |
|---|---|
| Former Name | ROXANNE UNDERCUFFLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: NJ 40QB00294000) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MD A3897) |
| Enumeration Date | 2015-10-09 |
| Last Update Date | 2015-10-09 |