| NPI | 1790749117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01354000) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT017419) |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2010-12-20 |