| NPI | 1972906980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ 40QA01555400) |
| 225100000X Physical Therapist (Licence: NJ 40qa015554000) | |
| Enumeration Date | 2014-10-03 |
| Last Update Date | 2016-10-27 |