| NPI | 1962596064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01327100) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305204829) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2010-05-13 |