| NPI | 1790080612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251G0304X Physical Therapist, Geriatrics (Licence: NJ NJ40QA00470600) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ NJ40QA00470600) |
| 2251P0200X Physical Therapist, Pediatrics (Licence: NJ NJ40QA00470600) | |
| Enumeration Date | 2011-01-25 |
| Last Update Date | 2011-01-25 |