| NPI | 1558654319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01172900) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT23450) |
| Enumeration Date | 2011-05-25 |
| Last Update Date | 2011-05-25 |