| NPI | 1558612796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01454700) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT022337) |
| Enumeration Date | 2012-09-27 |
| Last Update Date | 2012-09-27 |