| NPI | 1649524828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 20289) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01455900) |
| Enumeration Date | 2012-11-09 |
| Last Update Date | 2012-11-09 |