| NPI | 1972540904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA00364400) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ 40QA00364400) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2019-12-30 |